目的：观察角膜胶原交联(CXL)联合RGPCL治疗圆锥角膜的临床效果。

方法：选取2015-01/2017-01在我院行去上皮加速CXL治疗的进展期圆锥角膜患者51例51眼，根据治疗方式分为A组(30眼，行CXL后配戴框架眼镜)和B组(21眼，行CXL后配戴RGPCL)。分别于治疗前和治疗后12mo观察两组患者最佳矫正视力(BCVA)、等效球镜度(SE)及角膜前后表面形态。

结果：治疗前，两组患者BCVA、SE及角膜形态各参数\〖角膜前表面最小曲率和最大曲率(K1和K2)、平均角膜曲率(Km)、角膜最大曲率(Kmax)、角膜顶点厚度、角膜最薄点厚度\〗均无明显差异(P>0.05)。治疗后12mo，B组患者BCVA优于A组(0.11±0.03 vs 0.26±0.16)，角膜顶点厚度低于A组(431.8±14.41μm vs 461.38±32.68μm)(均P<0.05)，其余各参数两组之间均无明显差异(P>0.05)。

结论：CXL治疗圆锥角膜可延缓或控制圆锥角膜的进展，联合配戴RGPCL可有效改善矫正视力。

METHODS: From January 2015 to January 2017, 51 cases(51 eyes)of patients diagnosed with keratoconus and epithelium-off CXL treatment at the Eye Hospital of Nanjing Medical University were collected. The patients were divided into two groups according to whether they wore RGPCL or not after treatment. Group A: 30 eyes, epithelium-off CXL was removed and wear a framed mirror after treatment; Group B: 21 eyes, epithelium-off CXL was removed and RGPCL was worn after the condition was stable. Observed the best corrected visual acuity(BCVA), spherical equivalent(SE), minimum keratometry of the anterior corneal surface(K1), maximum keratometry of the anterior corneal surface(K2), mean keratometry(Km), maximal keratometry(Kmax), corneal vertex thickness, thinnest corneal thickness(TCT)before and 12mo after treatment.

RESULTS: No statistically significant differences were found before the therapy between the two groups in BCVA, SE, K1, K2, Km, Kmax, corneal vertex thickness, and TCT between the two groups(P>0.05). 12mo after treatment, BCVA in group B was significantly higher than that in group A(0.11±0.03 vs 0.26±0.16), the corneal vertex thickness of group B was lower than that of group A(431.8±14.41μm vs 461.38±32.68μm)(P<0.05), there was no significant difference in other parameters between the two groups.

CONCLUSION: Epithelium-off CXL can effectively delay or control the progression of keratoconus. Wearing RGPCL after treatment can effectively improve BCVA.